| NPI | 1679902480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: LA 4181) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: TX 32286) |
| Enumeration Date | 2013-11-03 |
| Last Update Date | 2015-05-08 |