| NPI | 1265578991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NH 977) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 111193) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2007-07-09 |