| NPI | 1164890059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 252311) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KY 7083) |
| 1041C0700X Social Worker, Clinical (Licence: KY 7083) | |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2016-11-17 |