| NPI | 1649614553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L14037) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 54624) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2024-02-01 |