| NPI | 1639662273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904013187) |
| Additional Taxonomies | 104100000X Social Worker |
| 104100000X Social Worker (Licence: IA 090719) | |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2022-10-11 |