| NPI | 1750652988 |
|---|---|
| Former Name | LISA RAE BURCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L13418) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA LW60254612) |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2023-05-10 |