NPI | 1780257816 |
---|---|
Former Name | COLLEEN LUCILLE ANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: WA SC61222024) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG61192849) |
Enumeration Date | 2021-07-16 |
Last Update Date | 2023-02-20 |