| NPI | 1407321383 |
|---|---|
| Former Name | BRENDA LOUISE MAHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2019-01-11 |