NPI | 1104299288 |
---|---|
Former Name | AMY BRUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L15904) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WY LCSW-974) |
1041C0700X Social Worker, Clinical (Licence: ME LC19714) | |
Enumeration Date | 2015-11-11 |
Last Update Date | 2025-08-07 |