NPI | 1235595943 |
---|---|
Former Name | MARIA CONNIE LOPEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW018917) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW6295) |
Enumeration Date | 2016-01-11 |
Last Update Date | 2025-02-07 |