| NPI | 1821325127 |
|---|---|
| Former Name | GRACE GARDNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2016-08-08 |