| NPI | 1649696535 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW12168) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL PSW 918) | 
| Enumeration Date | 2014-03-15 | 
| Last Update Date | 2019-01-21 |