| NPI | 1104090786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 123618) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: UT 13766641-3501) |
| 1041C0700X Social Worker, Clinical (Licence: ME LC23737) | |
| 1041C0700X Social Worker, Clinical (Licence: CA 18544) | |
| 1041C0700X Social Worker, Clinical (Licence: VT 089.0235502TELE) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2026-04-14 |