| NPI | 1629552807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LICSW1140653) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2025-11-17 |