NPI | 1811470891 |
---|---|
Former Name | AMANDA DUVON DENHAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 086432) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 75897) |
Enumeration Date | 2018-09-14 |
Last Update Date | 2018-09-14 |