| NPI | 1740932607 |
|---|---|
| Former Name | ELYSIA OUDEMANS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 10299) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904015085) |
| 1041C0700X Social Worker, Clinical (Licence: DC LC2000002110) | |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2023-07-10 |