| NPI | 1104973817 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I-0004741 OH LISW)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 104987- LICSW)  | 
| Enumeration Date | 2007-01-04 | 
| Last Update Date | 2019-08-16 |