| NPI | 1063862936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904007808) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-12229) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2016-06-21 |