| NPI | 1336640119 |
|---|---|
| Former Name | MIKAELA RAE HUDDLESTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WV DP00942742) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WV CP00942742) |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2021-09-15 |