| NPI | 1811294440 |
|---|---|
| Former Name | TRACY E JENNERWEIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW00482) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 007543) |
| 1041C0700X Social Worker, Clinical (Licence: MA LICSW127069) | |
| 1041C0700X Social Worker, Clinical (Licence: FL TPSW4022) | |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2024-07-24 |