NPI | 1457633752 |
---|---|
Former Name | AMANDA POLZIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C011779) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 119185) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-09-13 |
Last Update Date | 2022-05-03 |