NPI | 1326302555 |
---|---|
Former Name | BROOKE NICOLE ANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041S0200X Social Worker, School (Licence: MA 507087) |
Additional Taxonomies | 222Q00000X Developmental Therapist |
Enumeration Date | 2012-07-03 |
Last Update Date | 2020-12-22 |