NPI | 1588029235 |
---|---|
Former Name | GENEVIEVE DEZYREE HANES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801102861) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801115637) |
Enumeration Date | 2015-12-23 |
Last Update Date | 2024-10-07 |