| NPI | 1609205301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 12502) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 50835) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2013-11-04 |