| NPI | 1831672195 |
|---|---|
| Former Name | VERONICA MCKISSACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801116002) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801097720) |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2023-06-28 |