| NPI | 1609412139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 256306) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 7230) |
| 1041C0700X Social Worker, Clinical (Licence: OR L10208) | |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2022-03-07 |