| NPI | 1104170265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 083849) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 087776) |
| Enumeration Date | 2012-10-28 |
| Last Update Date | 2015-12-16 |