NPI | 1912303660 |
---|---|
Former Name | MAVISH KHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW005286) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA CSW005286) |
Enumeration Date | 2014-11-07 |
Last Update Date | 2022-05-25 |