| NPI | 1568173482 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW023267) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW007553L) |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2024-05-09 |