NPI | 1619216926 |
---|---|
Former Name | DIANE ELLEN LEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 115973) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2013-02-06 |
Last Update Date | 2014-09-10 |