| NPI | 1659773091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 088293) |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker, Clinical (Licence: FL 19637) | |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2022-10-21 |