| NPI | 1346606944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 1017957) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NY 069827-R (INACTIVE)) |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2016-01-12 |