| NPI | 1720528862 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 254328)  | 
| Additional Taxonomies | 104100000X Social Worker (Licence: KY 7192)  | 
| Enumeration Date | 2017-03-07 | 
| Last Update Date | 2021-06-24 |