| NPI | 1164977039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904008913) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 1041C0700X Social Worker, Clinical (Licence: FL sw18445) | |
| 363A00000X Physician Assistant (Licence: FL 18445) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 18445) | |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2023-10-27 |