Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker |
NPI | 1003080821 |
---|---|
Provider Name | Mrs. Sue Ann Joy-Smith |
First Address | Stockton, CA 95202-1552 |
Second Address | Stockton, CA 95202-1306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2008 |
Last Update Date | 11/02/2014 |