NPI | 1659819266 |
---|---|
Former Name | CHELSEY LYNN BENNETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: LA 14081) |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: LA 14081) |
Enumeration Date | 2017-02-02 |
Last Update Date | 2017-02-02 |