NPI | 1407073950 |
---|---|
Former Name | MARY BRIDGET KILLEAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS21199) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 075755) |
Enumeration Date | 2007-04-19 |
Last Update Date | 2013-01-18 |