| NPI | 1508354622 |
|---|---|
| Former Name | JENNIFER COLLEEN GRACENIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IL 149021997) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150102571) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2020-03-09 |