NPI | 1366871204 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149006887) |
Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 149006887) |
Enumeration Date | 2013-11-01 |
Last Update Date | 2020-02-25 |