NPI | 1326681719 |
---|---|
Former Name | MARISSA BLAIR BLUEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 104100000X Social Worker (Licence: OH I.2507069) |
104100000X Social Worker (Licence: KY LCSW00001119) | |
Enumeration Date | 2019-10-18 |
Last Update Date | 2025-09-18 |