| NPI | 1811402514 |
|---|---|
| Former Name | JENNIFER GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 090504) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 0806591) |
| 1041C0700X Social Worker, Clinical (Licence: NY 090504-01) | |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2022-08-18 |