| NPI | 1336028372 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 34859) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 12271-123) | 
| Enumeration Date | 2025-09-02 | 
| Last Update Date | 2025-09-02 |