| NPI | 1619307006 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW005983)  | 
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 090781-1)  | 
| Enumeration Date | 2013-11-21 | 
| Last Update Date | 2022-03-21 |