NPI | 1801567581 |
---|---|
Former Name | SARA MARIE THANE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN 7876) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-49513) |
Enumeration Date | 2021-09-23 |
Last Update Date | 2023-07-05 |