| NPI | 1366042251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KY 255102) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: IA 105206) |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2022-10-19 |