| NPI | 1255604617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 59698) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2021-01-05 |