NPI | 1649379389 |
---|---|
Former Name | MARY VIRGINA MORIARTY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA lw00004048) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA lw00004048) |
104100000X Social Worker (Licence: WA LW00004048) | |
Enumeration Date | 2006-09-21 |
Last Update Date | 2024-01-21 |