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 |