| NPI | 1134607294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LICSW120743) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2026-07-23 |