| NPI | 1770739609 |
|---|---|
| Former Name | IRIS ROSE TRAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.014111) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150.011585) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2012-01-05 |