| NPI | 1003106311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL SW11172) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 216706) |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2015-05-05 |