NPI | 1083976591 |
---|---|
Former Name | KELLY PAIGE SIEGEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05670100) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW015787) |
Enumeration Date | 2012-06-11 |
Last Update Date | 2019-03-14 |