NPI | 1063718716 |
---|---|
Former Name | JENNIFER ANN MALONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904008944) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: DC LC50080609) |
1041C0700X Social Worker Clinical (Licence: WV DP00943751) | |
Enumeration Date | 2011-01-28 |
Last Update Date | 2020-02-24 |