NPI | 1669535464 |
---|---|
Former Name | JACQUELINE ANN O'CONNELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904003411) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW - 12020) |
Enumeration Date | 2006-12-19 |
Last Update Date | 2018-03-19 |