| NPI | 1053642017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 2004022297) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: KS 2492) |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2010-01-14 |