| NPI | 1629270905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT 5323-LCSW) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: KS 5671) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2023-08-15 |