| NPI | 1407061047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 8719) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 8589) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2016-09-29 |