NPI | 1700949047 |
---|---|
Former Name | LISA DAWN DUNAWAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.014874) |
Additional Taxonomies | 261QM0801X |
Enumeration Date | 2006-12-18 |
Last Update Date | 2023-03-15 |