NPI | 1477909265 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 106520-1) |
Additional Taxonomies | 174400000X Specialist (Licence: NY 725806132) |
252Y00000X Early Intervention Provider Agency (Licence: NY 725806132) | |
Enumeration Date | 2016-05-11 |
Last Update Date | 2021-01-08 |