| NPI | 1912476318 |
|---|---|
| Former Name | KAYLA MARIE LE VINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904013718) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2022-02-14 |