Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 50961 | TX |
NPI | 1003004250 |
---|---|
Provider Name | Joanne Frances Carrubba |
First Address | Austin, TX 78750-2410 |
Second Address | Austin, TX 78758-7244 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2007 |
Last Update Date | 11/10/2007 |