| NPI | 1679133169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 095369) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IA 095369) |
| 1041C0700X Social Worker, Clinical (Licence: MO 2024027294) | |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2024-11-02 |