NPI | 1336445436 |
---|---|
Former Name | RANDI MICHELLE DRAKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 52553) |
Additional Taxonomies | 104100000X Social Worker (Licence: TX 52553) |
Enumeration Date | 2011-02-07 |
Last Update Date | 2015-08-17 |