NPI | 1235638859 |
---|---|
Former Name | JENNIFER LEE CRUTTENDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 29439) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 117488) |
Enumeration Date | 2018-02-09 |
Last Update Date | 2025-05-27 |