| NPI | 1558900787 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW023994) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW136855) |
| Enumeration Date | 2020-01-06 |
| Last Update Date | 2024-10-03 |