| NPI | 1679054621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 122262) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 221805) |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2019-11-13 |