NPI | 1518937861 |
---|---|
Former Name | SUSAN SHACKELFORD ENDERLIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW003872) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY R038364-1) |
Enumeration Date | 2006-01-26 |
Last Update Date | 2009-07-08 |