| NPI | 1801216452 |
|---|---|
| Former Name | MEREDITH SOURK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 03162) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 8888) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2023-06-20 |