| NPI | 1639775661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 125800) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 111167-01) |
| Enumeration Date | 2020-12-06 |
| Last Update Date | 2022-11-22 |