NPI | 1366073322 |
---|---|
Former Name | KYLIE MCCARVER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2019030412) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW020919) |
Enumeration Date | 2020-01-29 |
Last Update Date | 2021-09-08 |