| NPI | 1245856095 |
|---|---|
| Former Name | TINA RAE MANCUSO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2021-02-01 |