| NPI | 1518212307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 73-082612) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 72-083915) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2014-12-01 |