| NPI | 1639047822 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 125005) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 111365) |
| Enumeration Date | 2025-10-28 |
| Last Update Date | 2025-11-13 |