NPI | 1508306598 |
---|---|
Former Name | KELLY G CALVERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904011780) |
Additional Taxonomies | 104100000X Social Worker (Licence: MD 22265) |
1041C0700X Social Worker, Clinical (Licence: DC LC50082678) | |
Enumeration Date | 2017-02-24 |
Last Update Date | 2022-09-06 |