| NPI | 1639848658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 21755) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904010926) |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2021-09-13 |