NPI | 1528336609 |
---|---|
Former Name | ZOE TALLIDIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801102269) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 55713) |
Enumeration Date | 2011-12-05 |
Last Update Date | 2023-11-16 |