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 |