NPI | 1487128617 |
---|---|
Former Name | KATHLEEN H RYDER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 121686) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 121686) |
Enumeration Date | 2019-01-22 |
Last Update Date | 2019-04-29 |