| NPI | 1053869297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2018043963) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 8746) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2019-01-14 |