Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker |
NPI | 1003147760 |
---|---|
Provider Name | Sarah Hull |
First Address | Thorndike, MA 01079 |
Second Address | Ware, MA 01082-1616 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2010 |
Last Update Date | 20/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1300881 | (05) | MA |