| NPI | 1104862341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: ME LC3768) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NH LICSW298) |
| 1041C0700X Social Worker Clinical (Licence: MA LICSW1017961) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2007-07-08 |