| NPI | 1902631179 |
|---|---|
| Former Name | DESTENIE RAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW008831) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AL 5534C) |
| Enumeration Date | 2024-09-05 |
| Last Update Date | 2024-09-10 |