| NPI | 1003562448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 8895) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 27775) |
| Enumeration Date | 2022-02-24 |
| Last Update Date | 2022-12-14 |