| NPI | 1174179212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: 61411) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 61411) |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2021-01-04 |