NPI | 1356687396 |
---|---|
Former Name | LISA ANN NELSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C9311) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KS 4520) |
Enumeration Date | 2012-12-19 |
Last Update Date | 2023-03-28 |