NPI | 1578625539 |
---|---|
Former Name | JANE MASSIE MARBURY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: WI LCSW 594-123) |
Additional Taxonomies | 104100000X Social Worker (Licence: WI LCSW 594-123) |
Enumeration Date | 2006-12-15 |
Last Update Date | 2007-07-08 |