NPI | 1326671041 |
---|---|
Former Name | KATHRYN ELIZABETH MAYKA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 9932123) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 18907-130) |
104100000X Social Worker (Licence: WI 131431-121) | |
Enumeration Date | 2020-02-20 |
Last Update Date | 2022-05-11 |