| NPI | 1386307965 |
|---|---|
| Former Name | CHRISTINE LYNN JOHANNSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW025284) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW137911) |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2025-03-06 |