NPI | 1700279619 |
---|---|
Former Name | RHEA L ELLESTAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: WI 129639-121) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 9393-123) |
Enumeration Date | 2015-03-17 |
Last Update Date | 2024-03-24 |