NPI | 1437499886 |
---|---|
Former Name | KATELYN ELIZABETH BAXTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC14438) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW 13747) |
Enumeration Date | 2013-02-21 |
Last Update Date | 2015-04-08 |