| NPI | 1649258435 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NE 75)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NE 1240 LMHP)  | 
| 1041C0700X Social Worker, Clinical (Licence: NE 743 CMSW)  | |
| Enumeration Date | 2006-01-03 | 
| Last Update Date | 2023-08-23 |