| NPI | 1346839271 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2023001049) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2020038772) |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2024-07-11 |