| NPI | 1639229248 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW015970) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 20615) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2022-02-09 |