| NPI | 1366967903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA LCSW2121329) |
| Additional Taxonomies | 226000000X Recreational Therapist Assistant |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2025-11-03 |