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 |