| NPI | 1245696749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 100757) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 100757) |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-13 |