NPI | 1487197877 |
---|---|
Former Name | JEAN WOOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904009711) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09924544) |
Enumeration Date | 2016-12-02 |
Last Update Date | 2019-04-03 |