NPI | 1780676924 |
---|---|
Former Name | JANIS LYNN FISKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS20326) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OR 1609) |
Enumeration Date | 2005-08-15 |
Last Update Date | 2007-07-13 |