| NPI | 1083267124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OR L12107) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: ME LC17832) |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2020-11-16 |