| NPI | 1114476793 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LICSW127364)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 088901)  | 
| 1041C0700X Social Worker, Clinical (Licence: GA CSW009057)  | |
| 1041C0700X Social Worker, Clinical (Licence: WA LW60859065)  | |
| Enumeration Date | 2016-09-24 | 
| Last Update Date | 2024-10-09 |