NPI | 1699865634 |
---|---|
Former Name | CONNIE L AUSTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 156) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 499) |
1041C0700X Social Worker, Clinical (Licence: NE CMSW68) | |
Enumeration Date | 2006-10-13 |
Last Update Date | 2010-07-20 |