| NPI | 1063760163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 22399) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 081585) |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2018-01-02 |