NPI | 1952468829 |
---|---|
Former Name | KELLY GILL WELLS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60445728) |
Additional Taxonomies | 101Y00000X Counselor (Licence: AL 1880C) |
Enumeration Date | 2007-01-02 |
Last Update Date | 2020-05-02 |