| NPI | 1689977357 |
|---|---|
| Former Name | NICOLE SUSAN BRUSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW020213) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW126406) |
| Enumeration Date | 2010-12-17 |
| Last Update Date | 2022-07-21 |