| NPI | 1710495320 |
|---|---|
| Former Name | STEPHANIE JILL ATLAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW01664) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 112132) |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2018-07-10 |