| NPI | 1366054157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904013566) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH I.2506610) |
| Enumeration Date | 2020-08-21 |
| Last Update Date | 2025-08-22 |