NPI | 1578572228 |
---|---|
Former Name | KATHLEEN ETHEL O'MEARA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 3593) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WI 417-124) |
101Y00000X Counselor (Licence: WI 3593-123) | |
106H00000X Marriage & Family Therapist (Licence: WI 417) | |
Enumeration Date | 2006-08-05 |
Last Update Date | 2014-12-01 |