NPI | 1457709909 |
---|---|
Former Name | KATELYN MARIE RYAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: WI 129421) |
Additional Taxonomies | 104100000X Social Worker (Licence: MN 24914) |
1041S0200X Social Worker, School (Licence: MN 940710) | |
Enumeration Date | 2016-05-25 |
Last Update Date | 2016-05-25 |