| NPI | 1104420116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 103615) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 3536) |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2020-11-30 |