| NPI | 1679097224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 21768) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IA 072839) |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2020-08-27 |