| NPI | 1700249513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 122461) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KY 6094) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2020-09-23 |