| NPI | 1902939069 |
|---|---|
| Former Name | ALISA MARY GRACEFFA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 117705) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TN CSW7213) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2018-08-13 |