| NPI | 1104251610 |
|---|---|
| Former Name | JENNIFER LYNN LAROCQUE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC16696) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ME MC14236) |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2021-08-16 |