| NPI | 1083775191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: ME LC17332) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 111452) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2019-09-03 |