NPI | 1972057354 |
---|---|
Former Name | DANIELLE MANDIGO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904015072) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34007584A) |
Enumeration Date | 2016-08-15 |
Last Update Date | 2023-11-15 |