| NPI | 1669288833 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 098950-01) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 098950) |
| Enumeration Date | 2024-12-03 |
| Last Update Date | 2025-01-17 |