| NPI | 1528320181 |
|---|---|
| Former Name | NICOLE MARIE RUSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34007088A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA LICSW128164) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2024-08-08 |