NPI | 1174976625 |
---|---|
Former Name | JAMIE L MORT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 088113) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 087923) |
Enumeration Date | 2016-07-20 |
Last Update Date | 2024-12-19 |