| NPI | 1114691474 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 61904) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: LA 17427) | 
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2021-08-02 | 
| Last Update Date | 2022-09-28 |