NPI | 1568965358 |
---|---|
Former Name | REBECCA MARGOLIS DERAUD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801080766) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801080766) |
Enumeration Date | 2018-03-17 |
Last Update Date | 2020-09-16 |