| NPI | 1053661843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 008420) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 53775) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2014-01-23 |