| NPI | 1164791471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW15395) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ME LC5063) |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2022-07-21 |