NPI | 1730731621 |
---|---|
Former Name | VICTORIA ANNE OUTLAW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 104100000X Social Worker (Licence: NM M-11097) |
1041C0700X Social Worker, Clinical (Licence: NM SWB-2022-0986) | |
1041C0700X Social Worker, Clinical (Licence: NM M-11097) | |
Enumeration Date | 2019-07-11 |
Last Update Date | 2024-02-02 |