Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 1024469 | MA |
NPI | 1003021940 |
---|---|
Provider Name | Kristi Dawn Vargas |
First Address | Worcester, MA 01610-2476 |
Second Address | Worcester, MA 01610-2476 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 08/07/2007 |