| NPI | 1043708076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VT 089.0134181) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 72096535) |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2019-04-11 |