| NPI | 1356548309 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904007179) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 4754) | 
| Enumeration Date | 2007-07-02 | 
| Last Update Date | 2012-05-10 |