| NPI | 1700370632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 68726) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AK 130482) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2020-10-07 |