| NPI | 1104206655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149-018650) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150-013328) |
| Enumeration Date | 2015-05-30 |
| Last Update Date | 2016-07-14 |