| NPI | 1053673913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 2024002625) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: KS 05831) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2024-03-18 |