| NPI | 1861850356 |
|---|---|
| Former Name | HEATHER MCDONOUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 9364) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C007822) |
| Enumeration Date | 2016-01-29 |
| Last Update Date | 2016-01-29 |