NPI | 1891164018 |
---|---|
Former Name | BRANDI E HISSONG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-38106) |
Additional Taxonomies | 104100000X Social Worker (Licence: ID LMSW 35171) |
Enumeration Date | 2015-09-17 |
Last Update Date | 2022-11-09 |