| NPI | 1104192616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 28121) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: TN 3581) |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2017-02-27 |