NPI | 1962138073 |
---|---|
Former Name | MADISON DENI GISH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: DC LC200002361) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NV IC-1653) |
Enumeration Date | 2022-07-29 |
Last Update Date | 2023-12-09 |