NPI | 1497247175 |
---|---|
Former Name | JORDAN EVANS HERNICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904014564) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 69069) |
104100000X Social Worker | |
Enumeration Date | 2018-05-30 |
Last Update Date | 2023-04-03 |