Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 44SL06468400 | NJ |
NPI | 1003444019 |
---|---|
Provider Name | Mrs. Vanessa Stubbs |
First Address | Joint Base Mdl, NJ 08641-1662 |
Second Address | Lawrenceville, NJ 08648-4657 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2020 |
Last Update Date | 27/03/2020 |