| NPI | 1639474554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 117962) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 11962) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2024-06-19 |