| NPI | 1376949974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 087023) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801097207) |
| Enumeration Date | 2014-11-08 |
| Last Update Date | 2020-04-06 |