| NPI | 1053772988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 253690) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 7612) |
| Enumeration Date | 2016-03-20 |
| Last Update Date | 2019-09-10 |