| 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 |