| NPI | 1659463768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 007639) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 14201) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2014-11-25 |