NPI | 1669801114 |
---|---|
Former Name | KRYSTLYNN ANNE CUMISKEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO 09927834) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 20388) |
Enumeration Date | 2013-11-05 |
Last Update Date | 2024-08-12 |