| NPI | 1245302744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 004218) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KS 2667) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2007-07-08 |