NPI | 1629226865 |
---|---|
Former Name | JESSICA MARIE DOSAL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AL 2364C) |
Additional Taxonomies | 104100000X Social Worker |
104100000X Social Worker (Licence: AL 2575G) | |
Enumeration Date | 2008-08-29 |
Last Update Date | 2011-04-07 |