| NPI | 1114758174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 32666) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IA 127569) |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2024-08-12 |