NPI | 1902372311 |
---|---|
Former Name | MALLORY JAYMES BEERY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 7826) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 66515) |
Enumeration Date | 2018-10-23 |
Last Update Date | 2022-11-09 |