NPI | 1568053809 |
---|---|
Former Name | BRYNN OLIVER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 119189) |
Additional Taxonomies | 101Y00000X Counselor |
101YM0800X Counselor, Mental Health (Licence: CA 104184) | |
Enumeration Date | 2021-01-29 |
Last Update Date | 2023-11-14 |