NPI | 1508414368 |
---|---|
Former Name | KYLIE MARIE DEKRYGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801109983) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801104448) |
Enumeration Date | 2019-08-26 |
Last Update Date | 2021-11-16 |