| NPI | 1134574270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MS M8637) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: LA 15477) |
| 225800000X Recreation Therapist (Licence: MS 58766) | |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2023-11-11 |