NPI | 1740795608 |
---|---|
Former Name | MARY KATE TOMCZAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 7501-125) |
Additional Taxonomies | 104100000X Social Worker (Licence: WI 3740-226) |
Enumeration Date | 2017-12-13 |
Last Update Date | 2019-08-19 |