| NPI | 1629493473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT 12272) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 087906-1) |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2015-09-08 |