| NPI | 1710547799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 126565) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 226771) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2024-01-22 |