NPI | 1346474939 |
---|---|
Former Name | KATELYN DIANE DUDLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149019037) |
Additional Taxonomies | 104100000X Social Worker (Licence: IL 150015309) |
225C00000X Rehabilitation Counselor | |
Enumeration Date | 2009-05-11 |
Last Update Date | 2024-04-01 |