NPI | 1376284034 |
---|---|
Former Name | SHANDREKA THOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 59404) |
Additional Taxonomies | 104100000X Social Worker (Licence: TX 59404) |
Enumeration Date | 2022-04-06 |
Last Update Date | 2024-01-19 |