| NPI | 1174091052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW021947) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: PA SW013212L) |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2021-07-14 |