NPI | 1497052187 |
---|---|
Former Name | TANA LEE BETTRIDGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: UT 293442-3503) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2011-02-16 |
Last Update Date | 2022-02-07 |