| NPI | 1003154774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L6954) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2012033735) |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2018-05-30 |