| NPI | 1063430015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 06135) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 17288) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2011-03-21 |