| NPI | 1417472713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LICSW128519) |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker (Licence: MA 000227778) | |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2024-10-15 |