| NPI | 1851745632 |
|---|---|
| Former Name | VIRGINIA ELIZABETH WALLINGFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW22154) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LC200002935) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2023-11-29 |