NPI | 1972931905 |
---|---|
Former Name | TRESSA GUNSTONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L5882) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149015279) |
Enumeration Date | 2013-10-30 |
Last Update Date | 2013-10-30 |