NPI | 1437608452 |
---|---|
Former Name | ALYSSA SERRELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801113932) |
Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801105144) |
Enumeration Date | 2016-10-03 |
Last Update Date | 2024-07-16 |