| NPI | 1205584554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAFIAH HICKSON Licensed Clinical Social Worker 856-651-8776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2022-03-15 |