| NPI | 1780945436 |
|---|---|
| Former Name | JENNIFER MARIE MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 22737) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 080412-1) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2024-11-20 |