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 |