NPI | 1710479803 |
---|---|
Former Name | KRISTIN MARY COOK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.020291) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149020291) |
Enumeration Date | 2018-06-04 |
Last Update Date | 2021-09-10 |