NPI | 1700895679 |
---|---|
Former Name | TRACY ANNETTE RODRIGUEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW7766) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: GA CSW003832) |
Enumeration Date | 2006-08-07 |
Last Update Date | 2022-10-05 |