| NPI | 1053785956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2017030505) |
| Additional Taxonomies | 171W00000X Contractor (Licence: MO 2015000257) |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2022-07-21 |