NPI | 1992156871 |
---|---|
Former Name | LESLIE JUDKINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW17111) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WY LCSW-1003) |
Enumeration Date | 2016-06-22 |
Last Update Date | 2021-04-15 |