| NPI | 1467103473 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW025128) |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2025-02-06 |