| NPI | 1699142760 |
|---|---|
| Former Name | ALICIA MAMULA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CT 11029) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2020-06-24 |