NPI | 1134481062 |
---|---|
Former Name | JENNIFER GORDON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C009135) |
Additional Taxonomies | 133N00000X Nutritionist (Licence: NJ 44SL05664700) |
Enumeration Date | 2012-06-15 |
Last Update Date | 2023-08-15 |