| NPI | 1073630414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 27706) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2003005814) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2021-12-17 |