NPI | 1871107490 |
---|---|
Former Name | JETZEMANITH CAMPOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IL 149025152) |
Additional Taxonomies | 104100000X Social Worker |
Enumeration Date | 2020-09-01 |
Last Update Date | 2022-12-16 |