NPI | 1316563406 |
---|---|
Former Name | MIKAYLA SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL SW22310) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: FL ISW15477) |
Enumeration Date | 2020-06-24 |
Last Update Date | 2024-08-15 |