| NPI | 1740682913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 252993) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 7073) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2020-10-23 |