NPI | 1013387455 |
---|---|
Former Name | REBECCA DESSERTINE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 122778) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2015-09-28 |
Last Update Date | 2023-02-03 |