| NPI | 1265982904 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60706472)  | 
| Additional Taxonomies | 104100000X Social Worker (Licence: WA LW60706472)  | 
| 1041C0700X Social Worker, Clinical (Licence: OR L6918)  | |
| Enumeration Date | 2016-10-06 | 
| Last Update Date | 2018-03-21 |