NPI | 1780231209 |
---|---|
Former Name | KRYSTINA MARIE MCFADDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW61469251) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
104100000X Social Worker (Licence: WA SC61084532) | |
Enumeration Date | 2019-08-20 |
Last Update Date | 2023-12-28 |