| NPI | 1770192999 |
|---|---|
| Former Name | TAYLOR RAE SOUCY HORMBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2023033922) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2020019367) |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2023-09-06 |