| NPI | 1831587872 |
|---|---|
| Former Name | JILLIAN SHIVELY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-17802) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ LMSW-14090) |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2019-06-14 |