| NPI | 1093357733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904011766) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 59364) |
| 1041C0700X Social Worker, Clinical (Licence: MA 126746) | |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2023-12-21 |