NPI | 1457879504 |
---|---|
Former Name | JESSICA CAROL SUITOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 8123-C) |
Additional Taxonomies | 104100000X Social Worker |
Enumeration Date | 2017-09-08 |
Last Update Date | 2023-03-06 |