| NPI | 1639542897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 096057) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 21405) |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2018-06-14 |