NPI | 1942847868 |
---|---|
Former Name | BETHANY DAWN RICHARDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 68319) |
Additional Taxonomies | 104100000X Social Worker (Licence: TX 68319) |
Enumeration Date | 2019-12-10 |
Last Update Date | 2022-12-01 |