| NPI | 1336880848 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 000611) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 128131) |
| 1041C0700X Social Worker, Clinical (Licence: IL 150101647) | |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2024-10-09 |