NPI | 1134543184 |
---|---|
Former Name | REBECCA VEGA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 219312) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 122049) |
1041C0700X Social Worker, Clinical (Licence: NY 219312) | |
Enumeration Date | 2014-02-11 |
Last Update Date | 2021-07-22 |