NPI | 1770527616 |
---|---|
Former Name | PATRICIA LONG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60503508) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 20819) |
Enumeration Date | 2006-06-15 |
Last Update Date | 2021-11-23 |