| NPI | 1356958284 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09927489) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CO 0009923201) |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2024-07-31 |