| NPI | 1114243318 |
|---|---|
| Former Name | MARIANNE TERESA FENNESSY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: NY 490645) |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2010-04-13 |