| NPI | 1821653221 |
|---|---|
| Former Name | QUIANA LATRICE BROUGHTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG60955454) |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2022-03-22 |