NPI | 1487659397 |
---|---|
Former Name | ELLEN LOUISE HAMILTON PAYNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C2571) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TN LSW0000001199) |
1041C0700X Social Worker, Clinical (Licence: OH I-0003297) | |
Enumeration Date | 2005-06-16 |
Last Update Date | 2011-08-29 |