NPI | 1467048637 |
---|---|
Former Name | LAKETIA DESHAWN JONES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904014920) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DE Q5-0000057) |
Enumeration Date | 2020-12-11 |
Last Update Date | 2023-10-17 |