NPI | 1528254018 |
---|---|
Former Name | JENNIFER FAULCONER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW27793) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA LW60668237) |
1041C0700X Social Worker, Clinical (Licence: OR L4477) | |
Enumeration Date | 2007-09-19 |
Last Update Date | 2020-07-01 |