| NPI | 1104016815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 5539) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 6715-123) |
| Enumeration Date | 2007-07-29 |
| Last Update Date | 2014-12-10 |