| NPI | 1588948657 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA LCSW004363) | 
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: GA PTA002090) | 
| Enumeration Date | 2011-10-06 | 
| Last Update Date | 2021-01-21 |