NPI | 1639552672 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LICSW121623) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 121623) |
1041C0700X Social Worker, Clinical (Licence: CA 68514) | |
Enumeration Date | 2015-07-08 |
Last Update Date | 2023-05-17 |