NPI | 1881761229 |
---|---|
Former Name | ANNE MARIE HICKEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 1032791) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 651) |
1041C0700X Social Worker, Clinical (Licence: RI ISW01905) | |
Enumeration Date | 2006-11-29 |
Last Update Date | 2023-03-14 |