| NPI | 1104431741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: 104440) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 104440) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2025-01-07 |