| NPI | 1508842766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904005708) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MD 12066) |
| 1041C0700X Social Worker Clinical (Licence: DC 02362) | |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2007-07-08 |