| 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 |