NPI | 1720485485 |
---|---|
Former Name | ALYSSON MICHELLE LOVE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ND 6662) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MT 50732) |
1041C0700X Social Worker, Clinical (Licence: NV 8278-C) | |
Enumeration Date | 2014-11-24 |
Last Update Date | 2024-04-01 |