| NPI | 1649413808 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL 9152)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 051112)  | 
| Enumeration Date | 2009-04-16 | 
| Last Update Date | 2010-05-01 |