NPI | 1578942660 |
---|---|
Former Name | JAMIE BREITWIESER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05856900) |
Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL05843100) |
Enumeration Date | 2015-05-22 |
Last Update Date | 2023-05-30 |