| NPI | 1609151166 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 60019)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: GA CSW004159)  | 
| Enumeration Date | 2011-10-17 | 
| Last Update Date | 2022-10-06 |