| NPI | 1184241002 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 097757) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 109460) |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2025-02-03 |