| NPI | 1114118387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 15911) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OR L4478) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2018-06-16 |