NPI | 1477729085 |
---|---|
Former Name | COLLEEN MARIE HICKEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 078503-1) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05178500) |
Enumeration Date | 2008-05-03 |
Last Update Date | 2020-11-18 |