| NPI | 1730513979 |
|---|---|
| Former Name | AMYLYNN MEDEIROS |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 124881) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2024-08-21 |