| NPI | 1669470894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 03791) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 008912) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2007-07-08 |