| NPI | 1093168866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 8612) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MN 22426) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2022-07-26 |