| NPI | 1013151166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY 695) |
| Additional Taxonomies | 251C00000X (Licence: WY 695) |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2015-05-18 |