| NPI | 1538832514 |
|---|---|
| Former Name | NICOLE TUSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NH 2762) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 221574) |
| 1041C0700X Social Worker, Clinical (Licence: MA 124667) | |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2022-09-21 |