NPI | 1770981185 |
---|---|
Former Name | JENNIFER MICHELLE NELSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 087515-01) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: 00107972) |
104100000X Social Worker (Licence: NY 92417) | |
Enumeration Date | 2014-12-17 |
Last Update Date | 2022-03-21 |