NPI | 1588276406 |
---|---|
Former Name | MEREDITH SELWAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149017343) |
Additional Taxonomies | 1041S0200X Social Worker, School (Licence: IL 1890252) |
Enumeration Date | 2020-08-21 |
Last Update Date | 2022-08-19 |