| NPI | 1609316124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 122523) |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker, Clinical (Licence: MA 223306) | |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2020-08-10 |