| NPI | 1609143627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CT 004123) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NY 050117-1) |
| Enumeration Date | 2011-11-18 |
| Last Update Date | 2018-03-17 |