NPI | 1023746971 |
---|---|
Former Name | MARY ELLEN KANE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW022730) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 012440) |
Enumeration Date | 2022-08-09 |
Last Update Date | 2024-01-05 |