| NPI | 1053790790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 123509) |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker (Licence: MA 223516) | |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2021-07-22 |