| NPI | 1366962151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 2362) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OR 4650) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2017-06-22 |