| NPI | 1710074117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 114454) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 213607) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2009-01-06 |