| NPI | 1104343672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 254943) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 252758) |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2022-07-21 |