| NPI | 1740059328 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WA 61441076) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA SWIA.SC.61441076) |
| Enumeration Date | 2023-12-25 |
| Last Update Date | 2025-01-13 |