| NPI | 1336755784 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L30008) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA SWI.LW.70081228) |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2026-03-18 |