| NPI | 1831644319 |
|---|---|
| Former Name | KOURTNEY MARIE VAN ZANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IN 34008725A) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2020-02-10 |