| NPI | 1104278175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 65620) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: IA 085526) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2025-08-14 |