NPI | 1932645314 |
---|---|
Former Name | MEGAN CROLLARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: MO 2015035778) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2019005804) |
1041C0700X Social Worker, Clinical (Licence: IL 149.026385) | |
Enumeration Date | 2017-01-10 |
Last Update Date | 2025-04-24 |