| NPI | 1023697455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MN 30508) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 000224667) |
| 104100000X Social Worker (Licence: MA 000124033) | |
| 1041C0700X Social Worker Clinical (Licence: MA 000224667) | |
| 1041C0700X Social Worker Clinical (Licence: MA 000124033) | |
| Enumeration Date | 2021-04-04 |
| Last Update Date | 2022-01-04 |