| NPI | 1386292183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 106554-01) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 106554-01) |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2019-10-18 |