| NPI | 1639900988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MN 33713) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 229730) |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2024-08-09 |