| NPI | 1649893611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 59775) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MS C8894) |
| Enumeration Date | 2020-05-25 |
| Last Update Date | 2020-07-29 |