| NPI | 1619992096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 35698) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: LA 4609) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2007-07-08 |