| NPI | 1124462114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 4079) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 3925) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2015-07-06 |