NPI | 1730852062 |
---|---|
Former Name | ROSALIE HUGHES FAZIO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 228134) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2021-08-02 |
Last Update Date | 2022-07-05 |