| NPI | 1255440996 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149-000513) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 149-000513) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2024-07-12 |