| NPI | 1811394786 |
|---|---|
| Former Name | ELIZABETH WALDRUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CO CSW.09923728) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AR 2525-C) |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2016-01-11 |