| NPI | 1053974808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AK 114753) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 27999) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2019-10-01 |