| NPI | 1003965179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 12687) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NM I-3060) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2009-02-16 |