| NPI | 1164855359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MN 25086) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: IL 149.016054) |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2022-07-21 |