NPI | 1528753811 |
---|---|
Former Name | AMY JENSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VT 089.0135011) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 098155) |
Enumeration Date | 2023-04-11 |
Last Update Date | 2024-08-06 |