| NPI | 1730564766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 254329) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 095387) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2019-08-26 |