| NPI | 1164890877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 253029) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KY 7303) |
| 1041C0700X Social Worker, Clinical (Licence: KY 7303) | |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2019-11-06 |