| NPI | 1184010910 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 086021) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 090151) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2024-12-20 |