| NPI | 1811442791 |
|---|---|
| Former Name | JENNIFER LYNN GORDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM C-10706) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM X-09701) |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2024-05-09 |