| NPI | 1356599583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA4763) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149012972) |
| 1041C0700X Social Worker, Clinical (Licence: CA 23936) | |
| 1041C0700X Social Worker, Clinical (Licence: MA 117721) | |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2013-10-25 |