| NPI | 1245774819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C012121) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 221410) |
| 104100000X Social Worker (Licence: NC P011117) | |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2019-10-01 |