| NPI | 1558640839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 121989) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 3567) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2019-07-16 |