| NPI | 1619120631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05205300) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 028740-1) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2011-09-12 |