| NPI | 1063792984 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L16041) | 
| Additional Taxonomies | 104100000X Social Worker (Licence: FL SW2945) | 
| 1041C0700X Social Worker, Clinical (Licence: NC C015521) | |
| Enumeration Date | 2011-08-23 | 
| Last Update Date | 2025-04-16 |