| NPI | 1043651854 |
|---|---|
| Former Name | MARTHA PACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904008067) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: SC 12407) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2022-07-28 |