NPI | 1740857820 |
---|---|
Former Name | REGINA GRIBBLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.024137) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2021-06-08 |
Last Update Date | 2024-11-13 |