| NPI | 1114232840 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904006642) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 12204) | 
| 1041C0700X Social Worker, Clinical (Licence: DC LC3000815) | |
| Enumeration Date | 2010-08-18 | 
| Last Update Date | 2010-08-18 |