| NPI | 1164958559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 20537) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MN 20537) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2019-06-13 |