| NPI | 1093485500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CSW.09927595) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO CSW.09927595) | |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2021-10-05 |