| NPI | 1194191338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 24046) |
| Additional Taxonomies | 104100000X Social Worker (Licence: LA 14300) |
| 1041C0700X Social Worker, Clinical (Licence: FL TPSW4232) | |
| 1041C0700X Social Worker, Clinical (Licence: AL 5886C) | |
| 1041C0700X Social Worker, Clinical (Licence: NM SWB-2024-0027) | |
| 171W00000X Contractor | |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2025-07-05 |