| NPI | 1164828331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C010640) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 55947) |
| Enumeration Date | 2014-11-14 |
| Last Update Date | 2017-04-24 |