| NPI | 1063092690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: 48299) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MT 48299) |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2021-04-08 |