| NPI | 1457798183 |
|---|---|
| Former Name | KATHERINE MARIE WANNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 087899) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.017653) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2019-08-14 |