| NPI | 1396068250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 68560) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: IL 149014389) |
| 1041S0200X Social Worker School (Licence: IL 2240650) | |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2019-12-04 |