| NPI | 1497203210 |
|---|---|
| Former Name | MARJORIE ROSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW18592) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 11859) |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2022-03-15 |