NPI | 1568938686 |
---|---|
Former Name | SARA ANN MOODY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 66734) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2016021530) |
1041C0700X Social Worker, Clinical (Licence: VA 0904008930) | |
Enumeration Date | 2018-10-16 |
Last Update Date | 2019-05-20 |