| NPI | 1295733319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 27855) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WY LCSW-374) |
| 1041C0700X Social Worker, Clinical (Licence: WY 374) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2021-09-14 |