NPI | 1689027377 |
---|---|
Former Name | BRYNNE E HAVERKAMP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KS 5192) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KS 380) |
104100000X Social Worker (Licence: KS 10015) | |
Enumeration Date | 2016-07-18 |
Last Update Date | 2020-05-27 |