| NPI | 1124868419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 257040) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IA 125048) |
| Enumeration Date | 2024-05-25 |
| Last Update Date | 2025-11-20 |