NPI | 1639641236 |
---|---|
Former Name | JUDITH OR JUDY MARIA BRAVEHEART-JORDAN OR JORDAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM C-11189) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO 986105) |
Enumeration Date | 2018-12-19 |
Last Update Date | 2020-03-30 |