| NPI | 1699049304 |
|---|---|
| Former Name | TANYA KEHAULANI KOLLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60247128) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WA CG60156645) |
| Enumeration Date | 2012-02-27 |
| Last Update Date | 2012-02-27 |