| NPI | 1659480168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW004558) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 11294) |
| 1041C0700X Social Worker, Clinical (Licence: TX 5001) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2024-05-01 |