| NPI | 1902821879 |
|---|---|
| Former Name | SHANA BETH RICKETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904005342) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 16213) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2013-09-09 |