| NPI | 1194009647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 217839) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 068944-1) |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2012-03-12 |