NPI | 1326543364 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-16956) |
Additional Taxonomies | 171000000X Military Health Care Provider (Licence: AZ LCSW-16956) |
Enumeration Date | 2018-03-29 |
Last Update Date | 2023-07-31 |