| NPI | 1295107555 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 13182)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 59256)  | 
| 1041C0700X Social Worker, Clinical (Licence: VA 0904012156)  | |
| Enumeration Date | 2015-10-27 | 
| Last Update Date | 2023-11-17 |