| NPI | 1689172603 |
|---|---|
| Former Name | TANEESHA MERSHELL TERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW007498) |
| Additional Taxonomies | 104100000X Social Worker (Licence: GA MSW008188) |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2021-04-16 |