| NPI | 1679889851 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 55131)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW016726)  | 
| 1041C0700X Social Worker, Clinical (Licence: CT 007383)  | |
| Enumeration Date | 2010-08-25 | 
| Last Update Date | 2023-04-12 |