| NPI | 1669822763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 8573 - 123) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 20291) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2017-02-24 |