| NPI | 1629190319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 54032) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 113275) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2013-02-06 |