| NPI | 1184041410 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW018126) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW130610) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2024-12-02 |