| NPI | 1649663691 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW006132) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: GA MSW006612) |
| 1041C0700X Social Worker, Clinical (Licence: NC P009249) | |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2022-07-21 |