NPI | 1801290713 |
---|---|
Former Name | CONNITA SMOOT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0011966) |
Additional Taxonomies | 104100000X Social Worker (Licence: MD G12055) |
1041C0700X Social Worker, Clinical (Licence: DE Q3-0000166) | |
Enumeration Date | 2014-10-21 |
Last Update Date | 2022-02-11 |