| NPI | 1053966622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW14500) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL SW14500) |
| 104100000X Social Worker (Licence: FL SW14500) | |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2019-08-09 |