| NPI | 1457897670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-22660) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MN 28860) |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2020-09-12 |