| NPI | 1104967652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 079054) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 074271-7) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2013-03-20 |