| NPI | 1184304818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 103864) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: TX 103864) |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2024-08-23 |