| NPI | 1649708462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 252640) |
| Additional Taxonomies | 251S00000X (Licence: AK 1005) |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2018-03-17 |