NPI | 1366818361 |
---|---|
Former Name | COLLEEN CASH RUPP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 12319) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC c012666) |
Enumeration Date | 2015-08-13 |
Last Update Date | 2020-05-04 |