NPI | 1962699405 |
---|---|
Former Name | VICKI LYNN MOHORICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 7609-123) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WI 2093-132) |
101Y00000X Counselor (Licence: WI 12502) | |
Enumeration Date | 2007-09-28 |
Last Update Date | 2024-07-10 |