| NPI | 1063502490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY R027975-1) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 1016973) |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2007-11-07 |