| NPI | 1073910154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 2012012516) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: KS 4272) |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2023-12-15 |