| NPI | 1295732485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: KY KY-1933) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 0638) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2025-09-11 |