| NPI | 1982268835 |
|---|---|
| Former Name | COURTNEY RAE CHRISTOFFERSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW005996) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 25859) |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2019-04-25 |