| NPI | 1194717546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT 22836) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CO 991958) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2017-02-15 |