| NPI | 1699325043 |
|---|---|
| Former Name | KELLY ANN EUSTACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 097540) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2026-07-10 |