| NPI | 1902345416 |
|---|---|
| Former Name | KELLY WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 8293-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AR 8293-M) |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2020-06-08 |