| NPI | 1487126918 |
|---|---|
| Former Name | SHANELL GRIDIRON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2018-12-21 |
| Last Update Date | 2020-10-23 |