| NPI | 1215405964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 123593) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 102081) |
| 1041C0700X Social Worker, Clinical (Licence: MA 102081) | |
| Enumeration Date | 2018-11-10 |
| Last Update Date | 2022-11-15 |