| NPI | 1801218698 |
|---|---|
| Former Name | JANICE MADDISON FILLMORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 10493826-3501) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2024-02-01 |