| NPI | 1326413527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 1027566) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: MA 1027566) |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2021-01-15 |