| NPI | 1679939219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW12066) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA LW60173115) |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2016-01-12 |