NPI | 1376890061 |
---|---|
Former Name | KATHERINE MELISSA BLANKEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW15081) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2012-08-13 |
Last Update Date | 2024-08-28 |