| NPI | 1003370958 |
|---|---|
| Former Name | JENNY SHEA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: ID 41682) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ID LMSW38297) |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2024-12-18 |