| NPI | 1063797165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WV DP00944131) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MD 15165) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2023-09-14 |