| NPI | 1245512581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 119630) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NH 1949) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2016-07-05 |