NPI | 1518601061 |
---|---|
Former Name | KAILEY ANNE IVY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW61078452) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA LW60875067) |
Enumeration Date | 2022-04-21 |
Last Update Date | 2024-05-12 |