Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 44SC05334900 | NJ |
NPI | 1003073701 |
---|---|
Provider Name | Laura Lee Jones |
First Address | Little Egg Harbor, NJ 08087-2086 |
Second Address | Tuckerton, NJ 08087-2669 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 20/05/2008 |