| NPI | 1104996057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: GA CSW005497) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 113497) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2016-06-23 |