NPI | 1427441260 |
---|---|
Former Name | AMANDA M KUBICEK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 101502) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA 81455) |
167G00000X Licensed Psychiatric Technician (Licence: CA 37965) | |
Enumeration Date | 2015-03-17 |
Last Update Date | 2021-06-14 |