| NPI | 1417428632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA 023524) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 99641) |
| 1041C0700X Social Worker, Clinical (Licence: MO 2025043452) | |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2026-01-20 |