NPI | 1912363441 |
---|---|
Former Name | GAIL MARIE SMALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L10767) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2016-01-13 |
Last Update Date | 2023-12-02 |