| NPI | 1285637595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 6530) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 13796) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2007-07-08 |