| NPI | 1063749174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 66923) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: IL 149015790) |
| Enumeration Date | 2009-11-10 |
| Last Update Date | 2019-09-03 |