| NPI | 1538542147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 69329) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P009680) |
| 1041C0700X Social Worker, Clinical (Licence: MA LICSW1120440) | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2024-12-02 |