| NPI | 1164086450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SD 5050) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 62088) |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2020-10-15 |