| NPI | 1679030944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2019-02-22 |
| Last Update Date | 2019-02-22 |