| NPI | 1104275122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: IA 092235) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.013715) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2018-09-06 |