| NPI | 1679721492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C014050) |
| Additional Taxonomies | 171W00000X Contractor (Licence: MD G11072) |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2021-12-02 |