| NPI | 1306489695 |
|---|---|
| Former Name | JODI HAGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 9748-123) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 129879-121) |
| Enumeration Date | 2019-10-20 |
| Last Update Date | 2023-09-29 |