| NPI | 1669640421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR 5004) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 111840) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2012-09-11 |