| NPI | 1962087940 |
|---|---|
| Former Name | MARIAH ELAINE FRITCHEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 13575) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2019022942) |
| 1041C0700X Social Worker, Clinical (Licence: WY 1199) | |
| Enumeration Date | 2021-03-11 |
| Last Update Date | 2021-03-11 |