| NPI | 1710236070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MD 06767) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: VA 0904007653) |
| Enumeration Date | 2012-09-02 |
| Last Update Date | 2012-09-02 |