NPI | 1750791885 |
---|---|
Former Name | FELICIA HOLLY TYSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 251S00000X |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C009740) |
Enumeration Date | 2014-04-28 |
Last Update Date | 2019-07-18 |