| NPI | 1609154319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 116713) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 214592) |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2014-05-14 |