| NPI | 1306247143 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW020618) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA SW131553) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2019-12-24 |