NPI | 1326664848 |
---|---|
Former Name | KAYLA EMMA ST JOHN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 126842) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2020-06-20 |
Last Update Date | 2023-08-31 |