| NPI | 1053973719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 35600) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OR L11238) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2026-03-24 |