NPI | 1427539840 |
---|---|
Former Name | MEGAN ERIIKA BERGSTEDT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 9398-123) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 26413) |
Enumeration Date | 2018-08-23 |
Last Update Date | 2021-10-18 |