| NPI | 1710056965 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2015005428)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KS 1316)  | 
| Enumeration Date | 2006-11-06 | 
| Last Update Date | 2023-11-21 |