| NPI | 1164636437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY PR045948-1) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY PR045948-1) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2009-02-04 |