| NPI | 1679195457 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 33821) | 
| Additional Taxonomies | 104100000X Social Worker (Licence: PA CW024040) | 
| 104100000X Social Worker | |
| Enumeration Date | 2020-05-14 | 
| Last Update Date | 2025-01-21 |