Individual
MS. EDITH HATHAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
069082-1
NY
1041C0700X
Clinical Social Worker
Primary
089.0060644
VT
Other
Enumeration date
07/19/2006
Last updated
02/01/2010
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