NPI | 1336604339 |
---|---|
Former Name | COURTNEY STEVENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KS 05333) |
Additional Taxonomies | 104100000X Social Worker (Licence: CO 0009922095) |
Enumeration Date | 2019-02-04 |
Last Update Date | 2023-02-13 |