| NPI | 1043608797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 253869) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 7196) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2020-02-28 |