| NPI | 1063065019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 13359) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 9614-123) |
| 1041S0200X Social Worker, School (Licence: MN 13359) | |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2025-01-09 |