| NPI | 1215063771 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW00005024)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: HI 3352)  | 
| 1041C0700X Social Worker, Clinical (Licence: MI 6801003699)  | |
| Enumeration Date | 2007-02-26 | 
| Last Update Date | 2007-07-08 |