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 |