| NPI | 1427388412 |
|---|---|
| Former Name | IVYSUE RICHARDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60842736) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG60829279) |
| 1041C0700X Social Worker, Clinical (Licence: NH 2922) | |
| 1041C0700X Social Worker, Clinical (Licence: NH 1923) | |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2023-03-15 |