NPI | 1770971970 |
---|---|
Former Name | JESSICA MCINTYRE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 8675-123) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 129571-121) |
1041C0700X Social Worker, Clinical (Licence: MN 21527) | |
Enumeration Date | 2014-12-23 |
Last Update Date | 2025-06-30 |