| NPI | 1114346061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: GA CSW006294) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MD 19722) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2019-01-11 |