| NPI | 1104219583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 094010-1) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 125121) |
| 1041C0700X Social Worker, Clinical (Licence: DC LC200001961) | |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2025-05-01 |