| NPI | 1134725153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MN 27115) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: OR L1736) |
| 1041C0700X Social Worker Clinical (Licence: SC 13688) | |
| Enumeration Date | 2020-12-06 |
| Last Update Date | 2020-12-06 |