| NPI | 1124508155 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 24203)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW019839)  | 
| Enumeration Date | 2018-08-20 | 
| Last Update Date | 2025-01-14 |