| NPI | 1447715289 |
|---|---|
| Former Name | KAYLA RENEE GROGG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WV BP00945167) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WV DP00945167) |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2021-08-11 |