| NPI | 1619422961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2005025545) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW013972) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2016-08-16 |