| NPI | 1356861793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 252364) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 013948) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2025-05-20 |