| NPI | 1952852436 |
|---|---|
| Former Name | BETSY LEANNE PACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: ID LMSW-38030) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ID LMSW-38030) |
| 104100000X Social Worker (Licence: TN 10930 (LMSW)) | |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2018-09-21 |