| NPI | 1073973665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW16341) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 12343) |
| 1041C0700X Social Worker, Clinical (Licence: VA 0904009357) | |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2021-11-24 |