| NPI | 1053538264 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 380164-3501) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NV 7460-C) | 
| Enumeration Date | 2007-04-19 | 
| Last Update Date | 2017-12-01 |