| NPI | 1679259600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 15399) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 127078) |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2023-10-13 |