Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 3766 | LA |
NPI | 1003251364 |
---|---|
Provider Name | Patricia Ann Borrello-Monie |
First Address | Kenner, LA 70065-2318 |
Second Address | Kenner, LA 70065-2318 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2013 |
Last Update Date | 01/05/2013 |