NPI | 1669814877 |
---|---|
Former Name | KATIE ROSE FRAZIER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 118990) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 218637) |
Enumeration Date | 2013-07-29 |
Last Update Date | 2015-12-16 |