| NPI | 1164591681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AK 743) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: OR L4684) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2011-05-27 |