NPI | 1558431650 |
---|---|
Former Name | DIANA YVONNE CERVONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: FL SW 8747) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 111950) |
103TS0200X Psychologist, School (Licence: FL SS 924) | |
103TS0200X Psychologist, School (Licence: MA Ed Psy 963 Allied MH) | |
Enumeration Date | 2006-11-08 |
Last Update Date | 2013-09-24 |