| NPI | 1104535467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 102755) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 118197) |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2026-04-22 |