| NPI | 1649514324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 5084) |
| Additional Taxonomies | 104100000X Social Worker (Licence: VA 0903001890) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2020-10-06 |