| NPI | 1275802530 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 005524) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 1029008) | 
| Enumeration Date | 2011-12-15 | 
| Last Update Date | 2011-12-15 |