| NPI | 1639110828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL 10695) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 105207) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2012-06-19 |