| NPI | 1720384639 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.1201528) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 5789) | 
| Enumeration Date | 2011-02-10 | 
| Last Update Date | 2014-11-07 |