| NPI | 1548479892 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 090406769) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 056891-R) | 
| Enumeration Date | 2007-05-22 | 
| Last Update Date | 2022-10-13 |