| NPI | 1255124574 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MD 33123) |
| Additional Taxonomies | 104100000X Social Worker (Licence: VA 0903004700) |
| Enumeration Date | 2025-05-28 |
| Last Update Date | 2025-10-07 |