NPI | 1396014742 |
---|---|
Former Name | CHRISTINE LYNN JOSEPH-RUSSO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW005913) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 079095-1) |
Enumeration Date | 2011-12-14 |
Last Update Date | 2017-01-30 |