NPI | 1982235610 |
---|---|
Former Name | ELIZABETH TAVARES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ND 5061) |
Additional Taxonomies | 101Y00000X Counselor (Licence: ND 5061) |
Enumeration Date | 2020-01-31 |
Last Update Date | 2020-04-09 |