Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 67511 | TX |
NPI | 1003571910 |
---|---|
Provider Name | I'esha Catrina Baber |
First Address | Georgetown, TX 78626-5152 |
Second Address | Georgetown, TX 78626-5152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2021 |
Last Update Date | 04/11/2021 |