| NPI | 1750102703 |
|---|---|
| Former Name | THEASHA BRYAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA SC61614385) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2024-10-22 |
| Last Update Date | 2024-11-28 |