NPI | 1720152598 |
---|---|
Former Name | BETTY LOIS GOOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC301816) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 05370) |
1041C0700X Social Worker, Clinical (Licence: VA 0904003159) | |
Enumeration Date | 2006-11-20 |
Last Update Date | 2012-01-30 |