NPI | 1780101030 |
---|---|
Former Name | JENNA FLATER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2021048520) |
Additional Taxonomies | 104100000X Social Worker (Licence: MO 2019010050) |
1041C0700X Social Worker, Clinical | |
101YS0200X Counselor, School | |
Enumeration Date | 2017-08-28 |
Last Update Date | 2023-05-25 |