| NPI | 1487194692 |
|---|---|
| Former Name | KATRICE LACHELLE MCCULLUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C011982) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P011010) |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2019-05-06 |