| NPI | 1104251917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 67557) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2004021552) |
| 1041C0700X Social Worker, Clinical (Licence: KS 1033) | |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2015-10-20 |