| NPI | 1104311364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CO 09925092) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: ME LC17278) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2019-04-29 |