| NPI | 1366260234 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA SW142097) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SL07222100) |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2025-06-09 |