NPI | 1396907028 |
---|---|
Former Name | SHANNON CASSIDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C014799) |
Additional Taxonomies | 104100000X Social Worker (Licence: MA 118149) |
104100000X Social Worker (Licence: NC C014799) | |
1041C0700X Social Worker, Clinical (Licence: MA 118149) | |
Enumeration Date | 2008-06-25 |
Last Update Date | 2022-07-20 |