Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003487653 |
---|---|
Provider Name | Holly N Little Van Straaten |
First Address | Danvers, MA 01923-2286 |
Second Address | Danvers, MA 01923-2286 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2021 |
Last Update Date | 06/07/2021 |