| NPI | 1154948982 |
|---|---|
| Former Name | NICOLE LEE MACWILLIAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW21255) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05864100) |
| Enumeration Date | 2020-06-27 |
| Last Update Date | 2023-04-27 |