| NPI | 1053018895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 102138) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801116177) |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2025-12-12 |