NPI | 1962496406 |
---|---|
Former Name | CHERYL LEE MCCORMICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: MO CS000807) |
Additional Taxonomies | 104100000X Social Worker (Licence: MO SW001784) |
Enumeration Date | 2005-09-09 |
Last Update Date | 2007-07-08 |