| NPI | 1548981582 |
|---|---|
| Former Name | ANDREA SUE DECKINGA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 150111370) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P018410) |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2025-05-14 |