| NPI | 1104200914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2021033147) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KS 5227) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2022-03-09 |