| NPI | 1669717104 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 8345472-3501) |
| Additional Taxonomies | 104100000X Social Worker (Licence: UT 8345472-3502) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2018-04-18 |