| NPI | 1699822882 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 04179)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LC300696)  | 
| Enumeration Date | 2007-01-03 | 
| Last Update Date | 2007-07-08 |