| NPI | 1548740277 |
|---|---|
| Former Name | COURTNEY ALYSSA LANCE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09925403) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 56505) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2018-08-21 |