| NPI | 1093065690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 120680) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 220675) |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2018-03-17 |