| NPI | 1386894186 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 116348) | 
| Additional Taxonomies | 222Q00000X Developmental Therapist | 
| Enumeration Date | 2008-09-29 | 
| Last Update Date | 2011-08-12 |