NPI | 1447602768 |
---|---|
Former Name | CHANEL GARDELLA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C011661) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P010641) |
Enumeration Date | 2016-07-11 |
Last Update Date | 2020-06-01 |