| NPI | 1205306420 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AK 157316)  | 
| Additional Taxonomies | 104100000X Social Worker (Licence: AK 140136)  | 
| 1041C0700X Social Worker, Clinical (Licence: NY 100891)  | |
| Enumeration Date | 2018-11-30 | 
| Last Update Date | 2020-09-28 |