NPI | 1568798759 |
---|---|
Former Name | CICELY D WATTLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149023539) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34006447A) |
Enumeration Date | 2009-10-23 |
Last Update Date | 2023-05-03 |