NPI | 1407167091 |
---|---|
Former Name | STACY TIMLIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 15989) |
Additional Taxonomies | 104100000X Social Worker (Licence: MD 15989) |
Enumeration Date | 2010-06-29 |
Last Update Date | 2023-10-27 |