| NPI | 1285237461 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM SWB-2024-0580) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM M-11397) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2025-01-09 |