| NPI | 1720574502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 105533) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 076012-1) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2018-07-05 |