NPI | 1801407531 |
---|---|
Former Name | FAWN M LIPE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34010641A) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: HI LCSW-4526) |
Enumeration Date | 2020-08-14 |
Last Update Date | 2023-12-05 |