NPI | 1982339479 |
---|---|
Former Name | KELLY KOLZOW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: IL 150.111855) |
Additional Taxonomies | 1041S0200X Social Worker, School (Licence: IL 2331484) |
Enumeration Date | 2022-07-19 |
Last Update Date | 2023-10-13 |