| NPI | 1710995600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MD 12509) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: DC LC303653) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2012-12-05 |