NPI | 1326382581 |
---|---|
Former Name | JOVANKA GEORGETTE MENA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW019567) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA SW128347) |
Enumeration Date | 2012-11-11 |
Last Update Date | 2019-03-05 |