NPI | 1881875615 |
---|---|
Former Name | KRIS MARIE CISCO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 67295) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-16769) |
1041C0700X Social Worker, Clinical (Licence: IL 149009815) | |
Enumeration Date | 2007-11-20 |
Last Update Date | 2019-03-26 |