| NPI | 1619674074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 26311) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: SC 26311) |
| Enumeration Date | 2023-02-15 |
| Last Update Date | 2024-06-25 |