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 |