| NPI | 1114198140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 1017371) |
| Additional Taxonomies | 1041S0200X Social Worker School (Licence: MA 1018371) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2008-03-18 |