| NPI | 1538558382 |
|---|---|
| Former Name | SHA-RON FIZZLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 63519) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 63519) |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2025-01-23 |