| NPI | 1710261490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: WA LW60537599) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 150007547) |
| 1041C0700X Social Worker, Clinical (Licence: WY 645) | |
| 1041C0700X Social Worker, Clinical (Licence: IA 007867) | |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2021-06-03 |