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Individual
EMILY ELISA HEAD
Active
Individual
EMILY ELISA HEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LICSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
119947
MA
1041C0700X
Clinical Social Worker
Primary
0904007468
VA
Other
Enumeration date
11/10/2010
Last updated
11/29/2022
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