NPI | 1306950928 |
---|---|
Former Name | STACEY ELIZABETH MARUSKA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 25075) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH I0600024) |
Enumeration Date | 2006-08-19 |
Last Update Date | 2020-06-22 |