| NPI | 1194753236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60061291) |
| Additional Taxonomies | 104100000X Social Worker (Licence: RI CSW00987) |
| 225700000X Massage Therapist (Licence: WA MA00025211) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2009-10-08 |