| NPI | 1134593205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 2020098) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2015-11-30 |