| NPI | 1215210851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-1013) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MT 1013-LCSW) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2019-03-12 |