| NPI | 1508291303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT 4643) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MT 4643LCSW) |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2018-06-18 |