| NPI | 1639693658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC23061) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2023-12-19 |