| NPI | 1720560212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 123815) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 223816-SW-LCSW) |
| Enumeration Date | 2018-08-31 |
| Last Update Date | 2022-11-09 |