NPI | 1942729025 |
---|---|
Former Name | KELLY J ERICKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: WI 9211-123) |
Additional Taxonomies | 104100000X Social Worker (Licence: WI 130696121) |
Enumeration Date | 2017-09-11 |
Last Update Date | 2019-05-29 |