| NPI | 1104185024 |
|---|---|
| Former Name | SALLY KESTENBAUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL 3015) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 26162) |
| Enumeration Date | 2012-05-12 |
| Last Update Date | 2012-05-28 |