| NPI | 1225199417 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW00648)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 107407-1)  | 
| Enumeration Date | 2006-12-12 | 
| Last Update Date | 2007-07-08 |