NPI | 1730647090 |
---|---|
Former Name | MICHELLE A KRC |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.021374) |
Additional Taxonomies | 104100000X Social Worker (Licence: IL 150.102806) |
Enumeration Date | 2019-03-06 |
Last Update Date | 2024-12-13 |