| NPI | 1588963110 |
|---|---|
| Former Name | LILLY JACQUELINE NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AL 2490C) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 1041C0700X Social Worker Clinical (Licence: FL SW19616) | |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2022-03-08 |