NPI | 1033341417 |
---|---|
Former Name | AZURE MARIE MAHUNIK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC13101) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ME MC12195) |
Enumeration Date | 2009-08-18 |
Last Update Date | 2011-07-25 |