| NPI | 1285415059 |
|---|---|
| Former Name | ELLEN JACOB |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL 24099) |
| Additional Taxonomies | 104100000X Social Worker (Licence: FL ISW18102) |
| Enumeration Date | 2023-10-09 |
| Last Update Date | 2025-01-10 |