| NPI | 1578070124 |
|---|---|
| Former Name | JESSICA MATCZAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW021262) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801102083) |
| 1041C0700X Social Worker, Clinical (Licence: MI 6801106500) | |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2020-12-27 |