| NPI | 1164780821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904007796) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MS 05731) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2022-05-18 |