| NPI | 1902920762 |
|---|---|
| Former Name | JENNIFER LYNN KUBIC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA MALICSW113239) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2024-02-15 |