NPI | 1386797710 |
---|---|
Former Name | DEVON LANE TAVANI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.0009932-SUPV) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH I0009932) |
1041C0700X Social Worker, Clinical (Licence: PA CW016888) | |
Enumeration Date | 2007-01-19 |
Last Update Date | 2020-12-01 |