NPI | 1821437005 |
---|---|
Former Name | STEPHANIE LAUREN BUTCHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW007096) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C011264) |
1041C0700X Social Worker, Clinical (Licence: SC SW13366CP) | |
Enumeration Date | 2013-06-20 |
Last Update Date | 2022-03-31 |