NPI | 1346719317 |
---|---|
Former Name | DIANA RAQUEL INTHAVONG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 175T00000X Peer Specialist |
Enumeration Date | 2018-11-19 |
Last Update Date | 2024-08-29 |