NPI | 1487306205 |
---|---|
Former Name | SUSAN RUTH STRAIT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: SC 4464) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
101Y00000X Counselor (Licence: SC 4464) | |
Enumeration Date | 2022-01-23 |
Last Update Date | 2024-01-15 |