NPI | 1003365826 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-18824) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.022232) |
Enumeration Date | 2016-09-22 |
Last Update Date | 2022-06-23 |