| NPI | 1356919997 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SD 6828)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 35076)  | 
| 1041C0700X Social Worker, Clinical (Licence: TX 116655)  | |
| Enumeration Date | 2021-06-10 | 
| Last Update Date | 2025-10-22 |