NPI | 1588179642 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-27245) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS-94146) |
Enumeration Date | 2017-12-11 |
Last Update Date | 2020-06-05 |