| NPI | 1679257810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW21616) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL SW21616) | |
| Enumeration Date | 2023-06-08 |
| Last Update Date | 2023-06-11 |