| NPI | 1649571464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 5040) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 122326) |
| 1041C0700X Social Worker, Clinical (Licence: NC C008050) | |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2021-01-14 |