NPI | 1588113252 |
---|---|
Former Name | AMANDA FISKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: NY 092986) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 911090151) |
Enumeration Date | 2016-09-23 |
Last Update Date | 2020-02-19 |