| NPI | 1730458639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TN 5913) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: VA 0904007694) |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2014-04-08 |