NPI | 1699968644 |
---|---|
Former Name | SUSAN M BLODGETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NY 011525) |
101YP2500X Counselor, Professional (Licence: MA 7875) | |
Enumeration Date | 2007-08-23 |
Last Update Date | 2023-12-02 |