NPI | 1912203449 |
---|---|
Former Name | HOLLY JOY VANDERBIE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801091711) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801091711) |
Enumeration Date | 2011-02-01 |
Last Update Date | 2016-11-30 |