NPI | 1366978058 |
---|---|
Former Name | LORIE ANNE MAYBERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA ASW89921) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW89921) |
Enumeration Date | 2017-05-02 |
Last Update Date | 2023-06-09 |