NPI | 1366948580 |
---|---|
Former Name | KAILA LEIGH NORTHCUTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO LCSW.09927312) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: SC 17182) |
Enumeration Date | 2018-04-05 |
Last Update Date | 2024-10-01 |