| NPI | 1518945633 |
|---|---|
| Former Name | MARLA JEAN MINER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34005109A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX S19336) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2012-04-09 |