| NPI | 1003336892 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.018736) |
| Additional Taxonomies | 1041S0200X Social Worker, School |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2022-07-21 |