| NPI | 1619656964 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2405499) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.1904063) |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2025-02-12 |