| NPI | 1154705879 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: csw01782) |
| Additional Taxonomies | 251B00000X Case Management |
| 104100000X Social Worker (Licence: RI csw01782) | |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2021-04-27 |