| NPI | 1063698785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 51555) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA CW015734) |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2009-11-03 |