Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003060336 |
---|---|
Provider Name | Mrs. Cassidy Christopher |
First Address | La Grande, OR 97850-2131 |
Second Address | La Grande, OR 97850-2131 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2008 |
Last Update Date | 13/11/2008 |