NPI | 1831858869 |
---|---|
Former Name | JORDAN RAY MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: GA MSW008172) |
Additional Taxonomies | 104100000X Social Worker (Licence: SC sw12393) |
1041S0200X Social Worker, School (Licence: GA 1804701) | |
Enumeration Date | 2021-12-17 |
Last Update Date | 2021-12-17 |