| NPI | 1104107911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 72 088102) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.014807) |
| Enumeration Date | 2011-09-07 |
| Last Update Date | 2013-03-12 |