NPI | 1801538103 |
---|---|
Former Name | JAMIE LYNN DIDOMENICO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 125683) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 224917) |
Enumeration Date | 2022-04-08 |
Last Update Date | 2023-10-02 |