NPI | 1932543162 |
---|---|
Former Name | TALYA KIM LAZAROW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: MD 24084) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS25299) |
Enumeration Date | 2013-04-18 |
Last Update Date | 2022-02-11 |