| NPI | 1306115969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MN 19209) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: WI 7902-123) |
| Enumeration Date | 2011-12-27 |
| Last Update Date | 2015-12-13 |