| NPI | 1669762563 |
|---|---|
| Former Name | KATRINA VANDEVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 10024-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NM C-9306) |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2024-01-26 |