NPI | 1801306055 |
---|---|
Former Name | ELIZABETH DIANA DICKERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801114019) |
Additional Taxonomies | 104100000X Social Worker |
Enumeration Date | 2017-10-02 |
Last Update Date | 2022-02-01 |