| NPI | 1639195167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 113397) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW9395) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2015-05-15 |