| NPI | 1679852305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L16216) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 54833) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2025-08-22 |