| NPI | 1720498165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 64997) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 090279) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2019-09-21 |