| NPI | 1104499789 |
|---|---|
| Former Name | LAUREN MARIE FANELLI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 092266) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 095554) |
| Enumeration Date | 2021-07-21 |
| Last Update Date | 2021-12-10 |