| NPI | 1245642040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 120517) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 120517) |
| 104100000X Social Worker (Licence: MA 120517) | |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2025-10-23 |