| NPI | 1720363468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 12371) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 8063-123) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2015-03-19 |