| NPI | 1073979936 |
|---|---|
| Former Name | MALLORY RUTH GAMER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW72307) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.017634) |
| 1041C0700X Social Worker, Clinical (Licence: CA ASW69967) | |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2019-11-20 |