NPI | 1649894015 |
---|---|
Former Name | MIRANDA THOMPSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 21658) |
Additional Taxonomies | 104100000X Social Worker (Licence: OK 8490) |
Enumeration Date | 2020-06-02 |
Last Update Date | 2025-07-31 |