| NPI | 1609204130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CT 010247) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 120974) |
| 1041C0700X Social Worker Clinical (Licence: NC C015768) | |
| Enumeration Date | 2013-10-18 |
| Last Update Date | 2023-09-20 |