NPI | 1235366675 |
---|---|
Former Name | JILL G MATTSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: MN 12033) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 12033) |
Enumeration Date | 2009-06-12 |
Last Update Date | 2009-06-12 |