Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 219295 | MA |
NPI | 1003192097 |
---|---|
Provider Name | Mrs. Jennifer Robinette Conniff |
First Address | Plymouth, MA 02360-2237 |
Second Address | Plymouth, MA 02360-2237 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2011 |
Last Update Date | 13/10/2015 |