| NPI | 1154255230 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VT 089.0137153) |
| Additional Taxonomies | 104100000X Social Worker (Licence: VT 089.0137153) |
| Enumeration Date | 2026-06-11 |
| Last Update Date | 2026-06-15 |