| NPI | 1598098980 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 252537) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2023-09-19 |