NPI | 1376181859 |
---|---|
Former Name | LASONJA RENEE LUCKETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
1041S0200X Social Worker, School | |
Enumeration Date | 2019-12-16 |
Last Update Date | 2019-12-16 |