| NPI | 1659677565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 4009) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 5888) |
| Enumeration Date | 2011-02-10 |
| Last Update Date | 2015-03-24 |