| NPI | 1578302659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 67894) |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker, Clinical (Licence: FL SW25007) | |
| 1041C0700X Social Worker, Clinical (Licence: LA 19196) | |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2025-08-16 |