| NPI | 1609471960 |
|---|---|
| Former Name | JA'LISE LYNN HANEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C10606) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MS M9293) |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2023-06-30 |