| NPI | 1073201190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LICSW1143152) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2026-04-27 |