NPI | 1619578911 |
---|---|
Former Name | SAMANTHA B BRIDGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LICSW123897) |
Additional Taxonomies | 1041S0200X Social Worker, School |
Enumeration Date | 2020-11-03 |
Last Update Date | 2023-04-07 |