NPI | 1528627098 |
---|---|
Former Name | JILLANA JOY PHILLIPS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 114684) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 25877) |
Enumeration Date | 2019-06-10 |
Last Update Date | 2023-04-10 |