NPI | 1003969064 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 117190) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY R018814) |
Enumeration Date | 2007-01-20 |
Last Update Date | 2012-10-30 |