| NPI | 1588217889 |
|---|---|
| Former Name | SALLY M BROCKSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34009603A) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IN 33007587A) |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2022-05-31 |