| 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 |