NPI | 1841699196 |
---|---|
Former Name | KRISTIE MIDENCE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 6182) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ 18711) |
1041C0700X Social Worker, Clinical (Licence: HI 4208) | |
Enumeration Date | 2014-08-21 |
Last Update Date | 2020-09-25 |