| NPI | 1659926509 |
|---|---|
| Former Name | VANESSA DIANA BUSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 9892-123) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2024-09-04 |