| NPI | 1619017142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L7014) |
| Additional Taxonomies | 251S00000X (Licence: MA 113862) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-18 |