| NPI | 1255386025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO LCSW 2006004078) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: KS LSCSW 1889) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2007-07-08 |