NPI | 1598166993 |
---|---|
Former Name | KATESHA SHANEE CROMWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904010149) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P009061) |
Enumeration Date | 2014-09-04 |
Last Update Date | 2023-11-27 |