NPI | 1487782918 |
---|---|
Former Name | GENEVIEVE LYNN CHARLTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 25003) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 17429) |
Enumeration Date | 2007-02-28 |
Last Update Date | 2010-09-27 |