| NPI | 1619975729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY 126) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO 989602) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2010-01-25 |