| NPI | 1104190891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 82295) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NY 085791-1) |
| Enumeration Date | 2012-02-28 |
| Last Update Date | 2021-04-29 |