| NPI | 1053509521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AZ LCSW12325) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: GA CSW002988) |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2007-10-10 |