| NPI | 1235445321 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AK 1262) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AK CSWS1262) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2018-05-11 |