NPI | 1922682202 |
---|---|
Former Name | AMY ROOT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801109628) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2021-05-12 |
Last Update Date | 2022-08-09 |