| NPI | 1437528718 |
|---|---|
| Former Name | JENNIFER E COSBY |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 2017015858) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MO 2014001115) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2021-12-22 |