NPI | 1497080550 |
---|---|
Former Name | REBECCA WENK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801086934) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA LW 00009656) |
Enumeration Date | 2009-10-07 |
Last Update Date | 2018-12-20 |