| NPI | 1518596006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-31469) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 052404) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2020-04-06 |