| NPI | 1053860569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VT 089.0134696) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 125489) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2022-09-19 |