| NPI | 1104354463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MA 000222755) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 091536) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2024-03-13 |