| NPI | 1912690116 |
|---|---|
| Former Name | SAVANNAH E BUSHMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-22443) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AZ LCSW-22443) |
| Enumeration Date | 2023-06-01 |
| Last Update Date | 2024-08-16 |