| NPI | 1164999272 |
|---|---|
| Former Name | MADISON M WEST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 9238-123) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 130239) |
| Enumeration Date | 2018-10-26 |
| Last Update Date | 2020-01-24 |