| NPI | 1104179977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NY 080053) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NY 0800053) |
| 1041C0700X Social Worker Clinical (Licence: NJ 44SC05502700) | |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2024-09-18 |