| NPI | 1164123360 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 116821) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL 24502) | 
| 1041C0700X Social Worker, Clinical (Licence: CT 15705) | |
| Enumeration Date | 2023-03-14 | 
| Last Update Date | 2025-09-28 |