| NPI | 1134508161 |
|---|---|
| Former Name | JENA RENEE ROSCIZEWSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 8805123) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 129729-121) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2018-03-17 |