| NPI | 1427473115 |
|---|---|
| Former Name | CHARLOTTE BRANTLEE JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 10347) |
| Additional Taxonomies | 104100000X Social Worker |
| 1041S0200X Social Worker, School | |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2014-03-04 |