| NPI | 1437195641 |
|---|---|
| Former Name | CHARLENE MARIE CARROLL HANISCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker (Licence: MN 12147) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2025-04-16 |