Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | ||
Y | 1041C0700X | Clinical Social Worker | 44SC06006200 | NJ |
NPI | 1003252644 |
---|---|
Provider Name | Mary Elizabeth Kindig |
First Address | Skillman, NJ 08558-2019 |
Second Address | Skillman, NJ 08558-2019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2013 |
Last Update Date | 13/08/2021 |