| NPI | 1639330681 |
|---|---|
| Former Name | RACHAEL LEE DERGO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.015129) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2023-11-22 |