NPI | 1487657557 |
---|---|
Former Name | TAMARA S BEIDLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 004666) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO SW004666) |
Enumeration Date | 2005-05-23 |
Last Update Date | 2025-09-11 |