NPI | 1770863979 |
---|---|
Former Name | CHRISONIA RENEICE THOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904015868) |
Additional Taxonomies | 101Y00000X Counselor |
104100000X Social Worker | |
1041C0700X Social Worker, Clinical (Licence: IN 34010681A) | |
Enumeration Date | 2011-08-19 |
Last Update Date | 2023-10-03 |