| NPI | 1134737034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SD LCSW-PIP6264) |
| Additional Taxonomies | 104100000X Social Worker (Licence: SD 5082) |
| 1041C0700X Social Worker, Clinical (Licence: CO CSW09928709) | |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2025-03-13 |