| NPI | 1164809190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY 1031) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL 13189) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2017-01-18 |