| 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: CA LCS 18544)  | 
| Enumeration Date | 2008-04-15 | 
| Last Update Date | 2022-05-20 |