| NPI | 1154606226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 119773) |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health (Licence: MA 119773) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2024-02-16 |