NPI | 1457399974 |
---|---|
Former Name | GWENDOLYN D. PARKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2003003710) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KS 2291) |
Enumeration Date | 2006-06-04 |
Last Update Date | 2008-01-18 |