| NPI | 1093033805 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 15202)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 9097)  | 
| Enumeration Date | 2010-05-04 | 
| Last Update Date | 2025-05-14 |