NPI | 1386037430 |
---|---|
Former Name | KELSEY BEACH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW019860) |
Additional Taxonomies | 104100000X Social Worker (Licence: PA SW132163) |
Enumeration Date | 2015-03-13 |
Last Update Date | 2022-09-28 |