| NPI | 1407830615 |
|---|---|
| Former Name | JOVANNA WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 070002) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 070002-1) |
| 1041C0700X Social Worker, Clinical (Licence: OK 7893) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2023-08-28 |