NPI | 1538304894 |
---|---|
Former Name | ELLEN CRUICE ROBERTSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 15836) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW 9160) |
Enumeration Date | 2008-12-15 |
Last Update Date | 2020-11-24 |