| NPI | 1346515640 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL 16737) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TN 6841) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2024-08-12 |