| NPI | 1568637254 |
|---|---|
| Former Name | LUEATA ANN KANNGIESSER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 05394) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 3078) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2021-03-31 |