| NPI | 1366035164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MA LCSW229626) |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker, Clinical (Licence: MA LICSW1142036) | |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2025-12-29 |