| NPI | 1245615533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 24516) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NE 3166) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2015-07-28 |