| NPI | 1013308329 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 29234)  | 
| Additional Taxonomies | 104100000X Social Worker (Licence: CA 70479)  | 
| 1041C0700X Social Worker, Clinical (Licence: WI 9995123)  | |
| Enumeration Date | 2015-02-09 | 
| Last Update Date | 2022-08-05 |