NPI | 1578946976 |
---|---|
Former Name | KYLA COLLECE FLUG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 5035) |
Additional Taxonomies | 104100000X Social Worker (Licence: KS 10630) |
1041C0700X Social Worker, Clinical (Licence: MO 2019026997) | |
Enumeration Date | 2015-07-02 |
Last Update Date | 2024-05-02 |