| NPI | 1073008199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 74559) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 11000) |
| Enumeration Date | 2018-06-30 |
| Last Update Date | 2018-06-30 |