NPI | 1497212732 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LICSW126958) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
1041C0700X Social Worker, Clinical (Licence: KY 256252) | |
Enumeration Date | 2019-02-22 |
Last Update Date | 2023-09-18 |