| NPI | 1649360959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY RO64383-1) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 104901) |
| Enumeration Date | 2006-10-15 |
| Last Update Date | 2007-07-08 |