| NPI | 1679093629 |
|---|---|
| Former Name | JESSICA PAVAO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW02964) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 119785) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2022-04-13 |