| NPI | 1356712954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 60076) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 121295) |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2019-02-05 |