| NPI | 1144838673 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2022003896) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MO 2017024660) |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2022-04-20 |