NPI | 1942667688 |
---|---|
Former Name | DEJERICA HEATH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW006163) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P009394) |
Enumeration Date | 2016-01-26 |
Last Update Date | 2020-01-14 |